- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,183.00 / $16,241.70 / $28,601.60
| Facility | | $10,183.00 | $16,241.70 | $28,601.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,746.00 / $15,981.11 / $22,659.46
| Facility | | $6,746.00 | $15,981.11 | $22,659.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,415.85 / $12,628.78 / $21,156.16
| Facility | | $9,415.85 | $12,628.78 | $21,156.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,683.37 / $11,333.00 / $15,577.88
| Facility | | $8,683.37 | $11,333.00 | $15,577.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $13,714.55 / $22,499.24
| Facility | | $6,409.00 | $13,714.55 | $22,499.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,673.80 / $16,003.82 / $21,941.50
| Facility | | $11,673.80 | $16,003.82 | $21,941.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $10,173.19 / $26,501.43
| Facility | | $3,775.00 | $10,173.19 | $26,501.43 |